According to statistics, about one in ten people in China may carry hepatitis B virus. The main reasons are mother-to-child transmission and exposure of adolescents and adults with weak immune function to hepatitis B virus.
Asymptomatic HBsAg carriers can be divided into three categories: ① I had hepatitis and didn't know it at all. Because of its mild clinical symptoms, liver damage and rapid recovery, it only shows HBsAg carrying state after illness. ② After repeated tests, the healthy carriers showed that their liver function was normal without any symptoms or signs. Even after liver biopsy, no pathological damage was found, and the liver tissue structure was complete. ③ Chronic persistent hepatitis and chronic active hepatitis were diagnosed by liver biopsy.
The asymptomatic HBsAg carriers of the first category should be followed up in medicine, and the liver function should be checked every three months to find out whether there is liver damage in time, and if there is liver damage, it should be treated in time. The asymptomatic HBsAg carriers of the second kind can work, study and work as usual, and most of them have a good prognosis. After a period of time, with the improvement of the body's autoimmune state, it can naturally turn negative. The asymptomatic HBsAg carriers of the third category should be treated as patients with the disease in time after being diagnosed with pathological damage to the liver.
Hepatitis B virus carriers are not equal to hepatitis B patients. However, asymptomatic HBsAg carriers are not really "healthy people". These people have viruses in their bodies, and they may copy or infect others. Therefore, they should not engage in catering services and conservation work. HBsAg carriers should pay attention to personal hygiene and public hygiene, develop good hygiene habits, and implement a separate meal system; Don't mix cosmetics with others. Women should also pay attention to menstrual hygiene to prevent menstrual blood from polluting daily necessities.
At present, there are three main principles for medical treatment of asymptomatic HBsAg carriers. ① Protect the liver: absolutely abstain from drinking alcohol, avoid overwork, keep a good mood, have reasonable nutrition, regularly check hepatitis B virus markers and liver function, take vitamin C and buckwheat powder for protecting the liver when necessary, enhance the body's resistance, strengthen liver nutrition and avoid blind medication. ⑦ Anti-HBV treatment: Use drugs under the guidance of specialists, such as interferon, lamivudine, anti-HBV immune RNA and Chinese patent medicines. ③ Family personal hygiene treatment: Other family members can be injected with hepatitis B vaccine to prevent infection. Asymptomatic HBsAg carriers can use 0? Soak and wash with 2% 84 disinfectant (20 minutes). Tableware can also be disinfected by cooking for 30 minutes or used alone.
In a word, HBV carriers generally have a good prognosis, not only a few of them can turn negative naturally, but also most of them are in a state of persistent and stable lifelong HBV carriers (about half of them have slight liver lesions, which are relatively stable and low-response state of persistent HBV infection and need treatment); But about 3% can develop into hepatitis, and the possibility of developing into liver cancer is much greater than that of non-carriers. As a carrier of hepatitis B virus, it is necessary to strengthen immune regulation and liver nutrition. Please refer to the new method of liver targeting high nutrition.
2. Four correct treatments for hepatitis B virus carriers (1) Don't feel sorry for yourself: hepatitis B is not terrible. What is terrible is that asymptomatic HBV carriers suffer the same discrimination and injustice as normal people in employment, job-hopping and further education.
In fact, most hepatitis B virus carriers are inactive in virus replication and relatively weak in infectivity. Only a few viruses will actively replicate and be contagious. Can effectively prevent hepatitis B virus infection. After the implementation of hepatitis B vaccination in Japan from 1980, the number of hepatitis B virus carriers dropped from 10% to 13% to 0? 8%~ 1? 3%。 After the implementation of hepatitis B vaccination in China from 65438 to 0992, especially for newborns, the carrier rate of hepatitis B virus has begun to show a gradual decline. It is estimated that through the unremitting efforts of two or three generations, the hepatitis B virus carrying rate in China can be reduced from the current 10% to below 1%, reaching or lower than the level of Japan and western developed countries.
Most asymptomatic HBV carriers have only residual virus in their bodies, and their replication is not active. Clinical liver puncture proves that it has little damage to the liver. Most hepatitis B virus carriers have no symptoms, and only a few people will feel tired and disappear after rest. 60% ~ 70% of HBV carriers are found through various physical examinations. In the physical examination, once you find yourself carrying hepatitis B virus, you should go to a regular infectious disease hospital and a liver disease hospital for a detailed examination.
During the examination, the doctor asks first and then checks. The questions include: whether there are symptoms such as frequent fatigue, loss of appetite, nausea, aversion to oil, yellow urine and dull complexion; Whether there is a family reunion; Whether there is a history of direct or indirect contact with hepatitis B patients; Have you ever taken drugs that are harmful to your liver? You can also ask if you have a history of drinking. The contents of the investigation include: ① signs. Whether there is dull complexion, liver palm, spider nevus, facial telangiectasia, yellow staining of skin and sclera, hepatosplenomegaly, mobile dullness, edema of both lower limbs, etc. ② Serological examination. Liver function, hepatitis B virus markers, see how active the virus is. ③ Imaging examination (B-ultrasound, CT). After "asking" and "checking", make a comprehensive judgment. If it is difficult to judge, liver biopsy should be done if necessary. Whether carrying hepatitis B virus is hepatitis can be judged by liver puncture, which is usually regarded as the "gold standard". For hepatitis B virus carriers without any symptoms, first, we should make dynamic observation. Go to the hospital for examination every 3 ~ 6 months. Second, develop good living habits and change habits that are harmful to the liver, such as drinking and smoking. Third, don't have psychological pressure and live like a normal person. Fourth, when suffering from other diseases, you should tell the doctor about yourself and tell the doctor that you are a carrier of hepatitis B virus. In this way, the doctor will consider whether the drug is harmful to the liver when taking the medicine.
(2) Don't take "turning negative" as a lifelong goal: In the minds of many patients, the fundamental purpose of treatment is to make the virus index turn negative, that is, all the so-called "big three yang" and "small three yang" turn negative, mistakenly thinking that hepatitis will be cured as long as the virus index turns negative. This misunderstanding has brought many problems: patients look around for good prescriptions and turn negative, but they often return disappointed after taking the medicine, or occasionally one or two indicators turn negative, but the good times do not last long and appear repeatedly. After some patients are treated, "Big Three Yang" really becomes "Small Three Yang". It is reasonable to say that the condition should be improved, but on the contrary, the condition has further deteriorated. If this happens, it shows that the negative transformation of the above virus has brought bad consequences. Most of these negative transformations are caused by virus mutation, which has various forms and complicated consequences.
According to statistics, the general marker of hepatitis B virus (commonly known as "two and a half") is "big three positive", among which 30% ~ 50% are hepatitis patients diagnosed by liver puncture, with more men than women. The evolution law of hepatitis B is that after 30 to 40 years, if there are no other mixed factors, it will develop into cirrhosis.
People with active replication of hepatitis B virus are highly contagious to others and are likely to suffer from hepatitis B themselves. If the replication is weak or not, the possibility of infection is small, and the chance of suffering from hepatitis is small. "Big Sanyang" virus replicates actively and is highly contagious, while "Little Sanyang" virus replicates weakly and is basically inactive, so people generally think that "Big Sanyang" is a serious illness and "Little Sanyang" is a minor illness. In fact, there are three conditions that really determine the severity of the patient's illness: ① A few patients with "small three positive" are still positive for HBV DNA, suggesting that virus replication is still active, which may be the result of HBV mutation. The patient's illness may be worse and develop faster, which should be paid attention to. ② No matter whether the patient is a "big three yang" or a "small three yang", if the liver function is normal and there are no obvious symptoms, they are all called hepatitis B virus carriers and cannot be diagnosed as hepatitis B patients. Most hepatitis B virus carriers were infected with hepatitis B virus in infancy. At that time, the body's immune system was not fully mature, and it was impossible to remove the virus. Hepatitis B virus was easily infected for a long time, thus becoming a chronic carrier. ③ Whether it is "Big Three Yang" or "Small Three Yang", if the liver function is abnormal or there are clinical symptoms and signs, such as hepatosplenomegaly, it should be judged as a patient with hepatitis B and needs active treatment.
(3) Hepatitis B virus carriers had better not be treated specially for the time being: Hepatitis B virus carriers account for 8% ~ 10% of China's total population (about10.4 billion people), and many hepatitis B virus carriers were discovered by accident during physical examination, and there was no obvious discomfort. Should these people be treated? Brief analysis and discussion are as follows.
Theoretically, hepatitis B virus carriers are high-risk groups and should be prevented and treated in time. The carrying state of hepatitis B virus is often the "latent state" of hepatitis B. This incubation period can be long or short, and the elderly can reach decades. The length of incubation period depends on the heredity, race, age, infection mode and other factors of the patient. Many patients with persistent and active hepatitis and even cirrhosis are often developed by hepatitis B virus carriers. It is generally believed that 15% ~ 20% of chronic hepatitis B virus carriers may evolve into dominant hepatitis. Therefore, the virus carrying state is more like an "untimely bomb" lurking in the human body, which may suddenly occur under the action of some external factors (such as severe fatigue, alcoholism, sadness and other factors) and internal factors (overlapping infection with other viruses, viral genetic variation and other factors). Therefore, it is appropriate to regard hepatitis B virus carriers as unstable high-risk groups, and timely prevention and treatment are very important.
From the actual situation, hepatitis B virus carriers are the most difficult to prevent and should not be treated. Hepatitis B virus carriers are mixed in the normal population, so it is impossible to follow up and isolate them every day. It is unknown when they may infect others and when they may get sick. There are also some hepatitis B virus carriers who not only follow up regularly, but also take drugs on time, such as interferon, thymosin, polycythemia, traditional Chinese medicine, etc., which have almost no obvious effect. "Big Three Yang" or "Big Three Yang", "Little Three Yang" or "Little Three Yang"; Some are getting worse and worse, leading to obvious hepatitis. Because of the carrier's own immune tolerance and the integration of virus and liver cells, it is still in a "helpless" situation. In addition, according to the characteristics of national conditions, it is also difficult to prevent and control. In order to find out how many hepatitis B virus carriers there are in China, we must first conduct a comprehensive examination nationwide, not to mention the difficulty and huge cost of organizing the work. It takes 50 ~ 80 yuan for a person to do a liver function and "two and a half" tests, which is nearly 10 billion yuan in the country; If the identified people still need treatment, the country will need more than 1000 billion yuan per capita. Moreover, these expenses are often "wasted money", which harms both the country and the individual. From this perspective, it is better for hepatitis B virus carriers not to receive special treatment for the time being.
From a comprehensive point of view, hepatitis B virus carriers should be treated according to the principles of prevention first, treatment second, "autonomy" first and "foreign aid" second. Not giving special treatment to hepatitis B virus carriers does not mean letting them go.
(4) Do a good job in the prevention and follow-up of hepatitis B virus carriers: Do a good job in the prevention and follow-up of hepatitis B virus carriers, prevent the infection of other infectious diseases, and inject hepatitis A vaccine and other infectious diseases vaccines; Prohibition of alcohol; Moderately participate in sports and leisure exercise to avoid excessive fatigue and have a regular life; Adjust mentality, be optimistic and open-minded; Check the liver function series and B-ultrasound regularly to find out whether the disease is pathological.
3. Hepatitis B decoction, a prescription for hepatitis B virus carriers, has the functions of strengthening the body resistance and eliminating evil, benefiting qi and detoxifying.
Indications of hepatitis B carriers.
Comprises 50g of Astragalus membranaceus, 50g of Gynostemma pentaphyllum, Poria cocos 15g, Radix Paeoniae Alba 15g, Radix Salviae Miltiorrhizae 15g, Radix Arnebiae 15g, Herba Scutellariae Barbatae 15g, Herba Hedyotidis Diffusae 15g, Radix Bupleuri 9g and Rhizoma Pinelliae preparata 9g.
Herba Agastaches, Rhizoma Atractylodis, Alismatis Rhizoma, Herba Artemisiae Scopariae, and Polyporus are added for those with dampness heavier than heat; If heat is heavier than dampness, Herba Artemisiae Scopariae, Radix et Rhizoma Rhei, Fructus Gardeniae and Fructus Forsythiae are added; Qi stagnation type: Radix Bupleuri, Fructus Aurantii, Radix Codonopsis, Atractylodis Rhizoma, and Rhizoma Dioscoreae; Yin deficiency type, Polygonatum sibiricum, Radix Rehmanniae Preparata, Cornus officinalis, Fructus Lycii and Polygoni Multiflori Radix are selected; Cryptotype, plus Taxilli, Schisandra chinensis, Ganoderma lucidum, etc.
Usage: daily 1 dose, decocted with water. Two months is 1 course of treatment. The total course of treatment is 2 ~ 4 months. Dose reduction in children.
Wu Keshan. Treatment of hepatitis B virus carriers 100 cases with hepatitis B decoction. Fujian Traditional Chinese Medicine,1992,23 (2): 37 Yigan Pill has the functions of clearing away heat and toxic materials, cooling blood and promoting blood circulation, resolving phlegm and resolving hard mass, dredging collaterals and softening the liver.
Indications of hepatitis B virus carriers.
Comprises Trichosanthes kirilowii 200g, Polygonum cuspidatum 500g, Salvia miltiorrhiza100g, Pangolin100g, Areca catechu100g, Hive100g, alum 25g and Fritillaria thunbergii 70g.
If the jaundice index is high, add Herba Artemisiae Scopariae100g; For patients with slightly higher transaminase, Fructus Schisandrae Chinensis or Ruby 100g is added.
Usage: Grind the medicine into very fine powder, refine honey into pills, 9 grams per pill, take 1 pill each time, three times a day, and take it with warm water. The dosage is 1 course of treatment, 45 days 1 course of treatment. After each course of treatment, the liver function was rechecked, and 65438 0 times was divided into two halves. Stop the drug 1 week, and then proceed to the next 1 course of treatment.
Originally from Zhang Feng and Li Heguo. Treatment of 58 HBsAg positive carriers with Yigan Pill. Sichuan traditional Chinese medicine, 1992, 10 (12): 30 Qingre Jiedu decoction has the functions of clearing away heat and toxic materials, protecting liver and benefiting gallbladder.
Indications of hepatitis B virus carriers.
Comprises Herba Hedyotidis Diffusae, Herba Scutellariae Barbatae, Rhizoma Polygoni Cuspidati, Herba Taraxaci, Herba Artemisiae Scopariae, Radix Bupleuri, Radix Salviae Miltiorrhizae, Radix Paeoniae Rubra, Radix Angelicae Sinensis and Radix et Rhizoma Rhei.
Usage: daily 1 dose, decocted in water twice, taken in the morning and evening, 1 month is 1 course of treatment, and two courses of treatment are continuous.
Origin Zhang Jian. Application of clearing away heat and toxic materials in hepatitis B virus carriers. Journal of traditional chinese medicine, Anhui,1995,7 (4): 26 Chaihu Yigan Decoction has the functions of soothing the liver, benefiting qi, tonifying the kidney and detoxifying.
Indications of hepatitis B virus carriers.
Comprises Bupleurum 10g, Cistanche deserticola 10g, Epimedium 10g, Morinda officinalis 10g, Radix Paeoniae Alba 15g and Herba Hedyotidis Diffusae 30g.
There is no abnormality in normal medication types (tongue pulse, spirit, food intake, eating habits, mood, etc.). ) and add Paris polyphylla and Scutellaria barbata; Spleen deficiency type (fat body, pale face, pale tongue, a small amount of thin white coating on the tongue surface, decreased food intake, listlessness, etc.). ) Rhizoma Atractylodis Macrocephalae, Poria, Semen Lablab Album and Rhizoma Dioscoreae are added; Radix Aconiti, Radix Curcumae, and Fructus Citri Tangerinae can be added for liver depression (yin deficiency, thin body, introverted personality, red and wet tongue, red color and thready pulse).
Usage: daily 1 dose, decocted in water twice, and taken in the morning and evening. Two months is 1 course of treatment.
Chen mutao 120 asymptomatic HBV carriers were treated with traditional Chinese medicine. Journal of traditional chinese medicine, Hubei, 1993, 15 (1): 29 shiquan yingshe decoction has the functions of clearing away heat and toxic materials, promoting diuresis and reducing swelling.
Indications of hepatitis B virus carriers.
Comprises ginseng, largehead atractylodes rhizome, tuckahoe, roasted licorice, angelica, chuanxiong rhizome, white peony root, prepared rhizome of rehmannia, astragalus root, cinnamon bark, dandelion and oldenlandia diffusa. (The original prescription has no dosage)
For patients with yin deficiency, add and subtract drugs, adding white peony root, reducing cinnamon bark and changing rehmannia root; For those with yang deficiency, cinnamon is reused; Patients with qi deficiency should reuse ginseng and astragalus; For those with blood deficiency, Angelica sinensis, Chuanxiong and Radix Rehmanniae should be reused; For patients with blood stasis, Paeonia lactiflora was changed to Paeonia lactiflora; Those with spleen deficiency should reuse Sijunzi decoction; Dandelion and Hedyotis diffusa are used for redundant (with thick red tongue coating).
Usage: decoct in water twice every day or every other day 1 dose, and take it in the morning and evening. Taking 100 dose is 1 course of treatment.
Wang Yuanyuan, Zhou Ruohui. 94 cases of HBsAg carriers treated with Shiquanyingshe decoction. Hebei journal of traditional chinese medicine Journal, 1995, 17 (2): 39 The recipe of warming kidney, invigorating spleen, detoxifying and activating blood has the functions of warming spleen and kidney, eliminating dampness and detoxifying, regulating qi and activating blood.
Indications of hepatitis B virus carriers.
Is prepared from dodder15-30g, epimedium15-30g, taxillus15-30g, astragalus15-30g, Hedyotis diffusa15-30g, Polygonum cuspidatum15-30g.
Usage: daily 1 dose, decocted in water twice, and taken in the morning and evening. Continuous administration 1 month is 1 course of treatment.
Origin: Hu Chaoyang, small swallow. Summary of 50 cases of asymptomatic HBsAg positive damage treated by warming kidney, invigorating spleen, detoxifying and activating blood. Hebei journal of traditional chinese medicine Journal, 1994, 16 (4): 1 Jieyang decoction has the functions of Yiyang, clearing away heat and toxic materials, invigorating spleen and eliminating dampness, nourishing blood and softening liver.
Indications of hepatitis B virus carriers.
Comprises 20g of Astragalus membranaceus, 20g of Smilax glabra, 20g of Scutellaria barbata, 20g of Salvia Miltiorrhiza, 20g of Radix Curcumae, 20g of Chinese yam, 20g of Coicis Semen, 20g of Euryale euryales, Rhizoma Curculiginis 15g, Chinese angelica 15g, Radix Paeoniae Alba 15g and aconite 5.
Usage: daily 1 dose, decocted in water twice, and taken 150 ~ 200ml in the morning and evening respectively, with 1 course of treatment for 2 months.
Journal of anhui traditional chinese medical college, 2000, 19 (5): 2.